Pain medications????

Discussion in 'The Watercooler' started by timer lady, May 18, 2008.

  1. timer lady

    timer lady Queen of Hearts

    The last year or so I've been in a great deal of pain from the multitude of diagnosis's I've been given. The latest is post herpetic encephalopathy & neurological & musculoskeletal disorder not otherwise specified. And of course the Cushings Disease.

    The head, neck & body pain is disabling. I cannot use the stairs in my home or walk with-o a cane or walker. I struggle to get into our shower (antique clawfoot bathtub with brass legs for sale) & I need to use a shower stool. I have a sit/stand stool in the kitchen but can only tolerate it for 10 minutes before I need to get back to a more comfortable position.

    I've been reluctant to use the pain medications I've been prescribed (vicodyn & methadone) because of the goofiness however today I took all the medications as prescribed & used the PRNs.

    I had the best day in a couple of months. The pain was relieved & I walked about the house. I made it up & down the stairs once; I sat & painted for 3 hours straight. (I didn't pace myself, but I felt so good!)

    Neuro doctor, Mayo doctor & GP all feel this level & dosage of pain medication is necessary. I'm terrified of addiction. The above listed docs aren't. I'm also terrified of becoming a total invalid because of the pain.

    My life has become very isolated & very restricted over the last year & the "recovery" period promises to be long, painful & the prognosis is unknown.

    husband is very concerned; he hates seeing me in pain & my inability to function with-o the pain medications. I can function at a much higher level than when I don't take these medications. My dad, who hadn't seen me in over a year, was shocked at my appearance & my physical decline.

    I told husband that I need to take whatever it takes to function at my highest level ~ just like I've always said with the tweedles.

    What are your thoughts on long term use of narcotic pain medications?
  2. flutterbee

    flutterbee Guest

    Like you, I would worry about dependence and addiction. But there comes a time when you have to weigh the benefits against the possible risks. It sounds like you had dramatic relief from the pain medications. If you continue with this much relief and it can give you some semblance of normalcy again, I'd go for it. The doctors will keep tabs on you. Let them worry about that.
  3. totoro

    totoro Mom? What's a GFG?

    Quality of life come to mind... Linda. I am so sorry for your struggles, I know you are not looking for sympathy! But this has to be very trying on you, mentally... to do this day in. In pain...
    When I was getting migraines that hospitalized me, I fought the pain "relief" husband fought with me... he would argue back and forth, but you are curled up, unable to move, nothing is touching it!!! Take the darn medications... After 2 weeks straight with a migraine, I realized going back and forth to the ER was not the answer! I could take my medications and then if I still got one I could take the medications that helped me deal with life!!! Pain medications.
    I know you are in a different situation, but I was afraid of taking them too often, the results, becoming tolerant to them...
    For 4 years now though I take them when it gets bad...
    I think you are a smart lady, you wont let yourself get out of control. You have too much going on!!!
    I hope you have continued relief!

    I was actually watching the birds in my yard today, mostly Hummingbirds, and thought of you.
  4. flutterbee

    flutterbee Guest

    I think of you too, Linda, when I'm watching the birds in my yard. Mostly cardinals and robins. Some sparrows and a couple pigeons, a few crows.
  5. Marguerite

    Marguerite Active Member

    Warning - long reply. But as you know, Linda - I've been there (and still am there).

    Linda, Dr K, my former (now retired) wonderful specialist used to worry (unnecessarily) about my amount of pain medications too. At one time he referred me to a rehab specialist and in his referral letter (which I read upside down on the rehab doctor's desk) he said he was concerned about my addiction to opiates. I was really angry when I read that, because I had been where you are now, had made enquiries and had worked through it. And now my doctor was kicking up a fuss over what I thought was now a non-issue!

    The rehab doctor had other concerns but still put me in hospital. I actually had to go in under Dr K because the rehab bloke didn't have any spare beds. Dr K was determined to get me assessed re addiction, but that issue got tossed out on the first day or so I was in. A non-issue, as I'd told him. The next three weeks were spent checking out other things.

    Now, the ward I was on happened to be an AIDS ward and was loaded heavily with addicts, hookers etc. ALL medications were closely supervised and it felt weird to me to have to take my strong opiates and open my mouth afterwards so they could check I'd swallowed them. But hey, they were just doing their job. My medications at the time were a 12 hour sustained release morphine, plus a paracetamol/codeine mix as needed.

    One thing I had to do while there - have an IVP. This required taking purgatives etc so the X-rays wouldn't be fogged by bowel shadows, etc. Now, a problem with purgatives is, my 12 hour medications would get swept out of my system so fast they wouldn't having time to work. And the side effects of suddenly not having morphine on board - diarrhoea. Which speeds up the loss of medications, which makes the diarrhoea worse, etc.

    So when I had to take the purgatives, I refused my morphine. The nurses were NOT happy with me, but I said, "There's no point."

    So I spent most of the day in a lot of pain, but I don't think I was in any more pain than I would have been anyway, thanks to the purgative. Then I had the test. The diarrhoea finally subsided. I asked for my morphine at last, at 3 pm.
    "It's not due until 9 pm tonight," they said.
    "But I didn't have any this morning," I said. "So technically, it's already 6 hours overdue. I just won't take any at 9 pm, then I'll take it at 9 am in the morning as usual."

    They just couldn't wrap their tiny little brain cells around this, considering I was on a ward populated mostly by addicts. I probably could have talked them around but I didn't have to. As it turned out, the IVP results arrived and a copy was put into a letter. I was finally discharged and as husband drove me home I took my morphine. At 4 pm.

    I guess what I'm trying to say - opiates, managed well, can make your life much easier, not harder. There are ways to make sure that what you do stays in the realm of good medical care and doesn't stray into addiction.

    I take morphine. It's in sustained release form. I also take the paracetamol and codeine mix as needed through the day for breakthrough pain. All of this is supervised by a pain specialist, who sees me every few months and authorises my GP to write the prescriptions. These have to be authority scripts, which means that the doctor has to telephone a central federal authority each time she writes me one of these. She gives them the prescription number and her registration number; they give her an authority number which is kept on file in her rooms and also written on the prescription. It's all closely monitored. I can only get enough from her for a month, and I can't go to another doctor for it all, it's all monitored. I also can't go back in a week for another month's supply, it's blocked until 3 and a half weeks. If I lose a prescription she can ring up and write me another one, but if the records show I'm getting careless, the central computer will flag it and send a "please explain" letter to the doctor. That has never happened with me, of course.

    I started out taking the paracetamol & codeine mix back when this pain first started, 24 years ago. At the time it was episodic so when I wasn't in pain I didn't take the painkillers. Paracetamol on its own wasn't enough; codeine on its own wasn't enough. Paracetamol potentiates opiates and vice versa. So does aspirin, but I can't take it. You may find that if you take the opiates, any breakthrough pain can easily be dealt with by taking paracetamol instead of more opiate.

    Then it went chronic and pain increased. various doctors tried different things, but I am here where I am after all these efforts. This is what works for me.

    Some people can't tolerate opiates and I am sorry for them. mother in law can't take them at all, can't even take codeine or pethidine. She had open heart surgery, and nothing stronger than paracetamol was permitted. Some idiot gave her pethidine and she was so ill she had to stay in hospital another 8 weeks.

    husband & I were once watching a documentary on how they manage pain in Britain - with heroin. There, end-stage cancer patients are able to go home and be productive right up until their last days, because when the opiate dose is matched to the pain level, you get practically no side effects. No 'high', no sedation (or very little), just the pain relief.

    And this is what I find. When I was first given morphine I think the dose was too strong. It sedated me a bit, I felt that odd, unpleasant (to me) sensation in my throat that is my muscles being so relaxed they've gone flabby. I found it didn't last for more than a few weeks. If I'd realised, I would have asked the doctor for a lower dose.
    I was taking 30 mg twice a day back then. This was MS Contin, the 30 mg is a purple pill.

    Then I developed a rash (after a few years). After doing some careful elimination, I worked out that it was the purple colouring in the MS Contin. The doctor gave me 10 mg tabs instead, I had to take 3. These were yellow and had an oily taste. They also tended to hit a little hard and then wear off about an hour early. I was also finding that at the end of the day, the cumulative stresses plus the pills wearing off meant that sometimes pain got out of control to the point where I would be vomiting from shock. Of course, this mean no pain pills staying down, so it meant a trip to hospital for a pethidine plus antiemetic shot.

    My pain specialist then switched me to a 24 hour morphine capsule called Kapanol. (I don't think it's available in the US, which is why, under current legislation, I will not be able to visit you guys.) Since switching to Kapanol, I've had hardly any emergency dashes to the hospital to stop vomiting and shock.

    I function. I do more than function, I can keep going and get so much done, but if pain gets out of control (if I get diarrhoea, for example) then I am like the Tin Man in Wizard of Oz, and I freeze up. Not from arthritis, this pain is neurological and muscular.

    Over the years I have needed to take more. Your body does 'acclimatise' to the opiates and it takes more to have the same effect. But also, my pain has increased. But by only increasing my dose according to need, I'm not getting the side effects.

    An important trick - never try to completely eliminate all pain. You still need to FEEL. To wipe out all pain takes you too close to the 'high' you MUST avoid. However, there is another sort of high which is the cessation of pain - you may also find you sleep, at least at first, purely because of the accumulated exhaustion the pain has caused over time. Take away the pain - and the fatigue hits you like a hammer. But once you've caught up on your rest, and you maintain control over your pain, you will (or should have) as much energy as the rest of your body permits.

    So, to summarise -

    1) never try to eliminate ALL the pain.

    2) Make sure a pain specialist is overseeing it all.

    3) Don't let the pain get out of control; instead, take what you need preferably just before you need it.

    4) Be prepared to vary the dose a little as your pain varies. Make sure there is wiggle room to lower the dose on good days, for example. But KNOW YOUR BODY.

    Dr K uses to say, "We'll get you well first, then we'll get you off the morphine."
    But over the years I've demonstrated to myself, if not to him - when I'm not in so much pain, I don't take the pain medications.

    I don't consider myself an addict, because I don't take it to get high. It doesn't interfere with my ability to function - if anything, it makes it possible for me to function because it gets my pain under control. I do get anxious if I'm cut off from my supply of morphine, but it's because I don't want the uncontrolled pain.

    Yes, my body is habituated to it. That will happen. It's unavoidable. If I don't take it, I get withdrawal symptoms. But frankly, withdrawal is no big deal, there are medications to handle it easily. Withdrawal is much easier than the pain. But I don't think I have anywhere near as much in the way of problems, as an addict stopping their drug.

    The danger signs to watch for - when you want a lot more, too soon. Analyse why. If it's because you're genuinely in more pain, you need to talk to the doctor in case the extra pain is due to a change in your condition.

    Because of the volunteer work I've done and the self-help groups I've been in, I've known a lot of people with chronic long-term pain and heard many different ways of managing it. Some people use alcohol - it's a fast way to become an alcoholic, I've seen. Some use painkillers, with varying success. For every person who I think had an addiction problem, I've known maybe fifty who did not.

    I've been on morphine now for about 12 years. At first I was on it and off it, as pain levels fluctuated. I had no trouble stopping it when the pain eased. But the pain hasn't been good enough for years now, for me to stop taking it.

  6. timer lady

    timer lady Queen of Hearts

    Heather, I believe yesterday was the day I had to choose life over pain; it just wasn't worth it to pass up on a viable medication.

    toto, pity is something I have little time for though I indulge on a semi regular basis of late.

    My bird sanctuary, my inability to sit long enough at my kitchen island to watch them & indulge in my nature journal is part of what pushed me to take pain medications yesterday. I've been missing too much of life of late.
    Marg, sweetie, I'd be worried if you wrote a short response! :bigsmile: I've taken note of all that you wrote & in fact will be copying your response to my computer. I know the next step will be a pain management clinic. I've never medicated myself to the point of absolute no feeling ~ that's just not me.

    Withdrawl from these medications cannot be any worse than coming off prednisone though I could be wrong. I have another 2-3 months to be completely off that.

    These pain medications are federally regulated as well; our doctors are hounded about prescribing pain medications rather than allowing their patients quality of life. It's depressing to think that my doctor has to explain the refills needed. I can't imagine what oncologists & doctors of other terminally ill patients have to go through.

    Thank you, ladies ~ I feel better. I'm not going to let the pain get away from me again. It's simply not worth it.
  7. busywend

    busywend Well-Known Member Staff Member

    Linda, I know the fear of the pain medication addiction - although mine was only after a hysterectomy when I had to take them for only a week. But, I was fearful even then - because they helped so much! LOL!

    My sister takes Vicodin daily. She has had back surgery and also has Fibromyalgia (sp). She has taken them so long she still has some level of pain even though she takes them 2x a day. It would be much worse without it.

    I figure take one day at a time. If you ever find yourself addicted to the pain medications, deal with it then.

    I am glad you are taking a step to improving your day to day living. It is important!
  8. Marguerite

    Marguerite Active Member

    OK, I'll try to keep this one shorter.

    Because I've done some digging on the topic over the years, mainly to assure myself that I'm on the right track as well as to have the information I need for anxious relatives, I can assure you - if you are taking the medications correctly, to treat pain, and not taking them because you enjoy some degree of euphoria on them, then if/when you ever can stop taking them you shouldn't get craving for it.

    Withdrawal symptoms don't last more than a few days, with acute withdrawal. You don't HAVE to step down. It helps if you do, it cuts withdrawal back to practically non-existent. But you're not going to have a life-threatening crisis if you suddenly decide to permanently flush all your pain medications.

    The withdrawal symptoms described on websites apply mainly to addicts, who take a great deal more and who also take widely varying amounts.

    And the list is:
    Abdominal pain
    Dilated pupils
    Goose bumps
    Runny nose

    The most I've had is diarrhoea, with maybe a little associated abdominal discomfort. And it makes sense - if you take opiate medication of any kind, it slows GI motility. You get constipation, developing from that point until you stop the medications (short course). But if you stay on the medications for any length of time, your body adapts. So the constipation eases and you go back towards a more normal pattern.
    So it stands to reason - you've been on them for, say, a fortnight, and then stop the medications. Your body simply is reacting back the other way - diarrhoea, until it adapts back to a normal gut motility again.

    I'm now on fairly high dose levels (well, it HAS been at least 12 years!) so I can begin to feel withdrawal if I'm a few hours late for my next dose. Sometimes, because the pain isn't too bad to remind me, it's the beginning of mild abdominal discomfort that reminds me I've not taken my medications for the day. No big deal. On days when I'm in less pain and I decide to take a lower dose, I get no withdrawal just from cutting back.

    I think if your body has become accustomed to a stable, consistent dose, then it has been able to adapt back to a normal pattern while taking the effect of the medications into account. Addicts, on the other hand, are unlikely to be maintaining fairly stable blood levels. If they were, they wouldn't be enjoying any high from the drug. To get a high, you need to spike your blood levels much higher than your base level. And the amount you need for the high increases dramatically, with opiates because your body adapts to them so fast. But there is a big difference between getting high, and getting pain relieved.

    But if, let's say, you are one of the unlucky ones who is withdrawing and experiencing a lot more of the symptoms on the list - there is good medical relief available to ease it right back. The short-term solution is to take just enough of the drug to ease the symptoms to a bearable level. This will be lower than your therapeutic dose. So as you can see, it is much easier to come of this (when taken for medical reasons only) than for addicts.

    Without any psychological component to the withdrawal, most of the problems addicts have to deal with are just not an issue.

    To summarise - over time, your body WILL become habituated to the drug, as it adapts to compensate for the other effects it has on your body. Also over time, the dose you need is likely to increase. But unless you find yourself chasing the drug for its euphoria (assuming you experience it) then you are not going to get addicted. The same goes for heroin - when used (as in Britain) for long-term chronic pain only, patients are able to come off it as soon as their pain is relieved. Again, they have to deal with any physical withdrawal, but there are no cravings. What is craved, is the euphoric high. Where you have no high - you have no craving.

    You know the really crazy thing? The reason I am on this particular medication regime, is - it's the safest, the gentlest on my shattered system, the one which will do the least damage to my body. There is nothing else that even comes close.

    Crazy, isn't it?

    The pain management specialist will definitely be the way to go. They can cut through so much red tape. For us, a GP may prescribe a small amount every once in a long while, but will get into trouble if they give you any more. As soon as a pain specialist is known to be involved, suddenly doors open.

    Strong recommendation though, from my bitter experience - once you're settled into a system that is working and a dose that is keeping everything well controlled, get a letter from your pain specialist to carry with you, that specifies your medication, your dosage and your diagnosis. If he includes his 24 hour contact details then kiss the ground he walks on. But it still may not be enough in a crisis - I was on holiday in an area noted for its attraction to addicts, when I became really ill. They dismissed my doctor's letter as a probably forgery and chose to not call him. They didn't give me any opiates at all (I was in more pain than usual plus I had been without morphine for 48 hours by this stage) but at least they got the other symptoms under control so I could keep my own pills down when I was finally able to take them. I suspect without the letter they wouldn't have even done that much.

    However, most of the time the hospitals are really understanding. The letter is a big help there.

    Seriously, Linda - once you get your pain under control you won't know yourself.

  9. mstang67chic

    mstang67chic Going Green

    I had posted recently on WC about my (step)dad and his colostomy surgery. The man has been in horrible pain for over a year and I truly believe that if he hadn't been able to have the surgery, he would have done something desperate. His pain levels were such that he was taking 250 mg of Morphine every SIX HOURS plus had liquid to take PRN for breakthrough pain. He is definately addicted. BUT...because of the pain medications, he was able to get through the past year. Not well, not coherent a lot of the time but he made it to the surgery. Will that be you? Probably not on the coherent part but you had a good day. You were able to get around better, paint for hours and feel better than you have in ages.

    I am lucky enough to not have had major health problems so I'm not talking from personal experience. BUT, if it were me I think I would take them. Yes, the fear of addiction would be there with me also but as someone else said, it's also a question of quality of life. You've been physically "down" for long enough that you know what your life is and would be like without the pain medications. Is this how you want to live? Would eventually weaning yourself off of the pain medications be worth the results now? This isn't something to take lightly but you have to look at the benefits vs. the downside. In my opinion, the benefits are great and while the downside is a big factor, it's one that I would worry about at a later date.

    On the other hand, maybe there's a happy medium in there somewhere. Maybe there's something out there that's not as addictive that will still work or at least work to the point that you can still do things. Talk to your doctor(s) about your concerns. They obviously think you need the medications even with the addiction possibility. In my step-dad's case, this was discussed but he needed it so much that it wasn't really an issue at the time. The plan now is for him to start seeing a pain management doctor to come off the Morphine. There are ways to do it and while it may take awhile when the time comes, it's possible.

    Whatever you decide, it's your life and your decision. We're here for you and I'm sending good vibes and lots of hugs.
  10. Star*

    Star* call 911


    A day described in your home could be a day in ours most days. I remember when DF started on Methadone. He's been on it 5 years now and without it can't manage and will go undoubtedly to a morphine pump. He's gained weight due to his inability to exercise due to the doctors NOT giving him high enough or correct doses of LTPM (long term pain medication/mgmt) with the weight gain due to inability to exercise his knees are now buckling and causing him more problems than his back. His depression was at an all time high.

    I did manage to get him into our family therapist and it helped him gain perspective on managing pain. We tried hypno therapy too, and I don't know if all those years of celebrating made him immune or negative to mind over pain. We were seeking out an accupuncturist but at 150 an hour / for a 45 minute hour? And the need to continually return over and over it wasn't an option. Our medicine cabinet used to boast some vitamin C, and a razor or two, some benadryl for the sniffles and took on quite a life of it's own. Had we gone black market we probably could have financed the five years it took Social Security to determine he was disabled instead of going into financial ruin and selling off our possessions.

    By the time the doctors had worked their way UP the narcotic pain ladder we were broke, fat, depressed, and still in major pain. And anyone who has to take care of a person in chronic pain knows why I said WE and not him. You suffer too, just a different type of pain.

    He takes 6 tabs of Methadone a day and Tegretol (i know it's a T pill) to sleep. He's tried taking less Methadone, but it doesn't work and he ends up in spasms and we go to the ER for many shots of morphine and deladud coctail as he can stand before he is out of pain.

    His frustration with himself is second only to his decision to take his pills on schedule, suffer from "the dumb" as he calls it because Methadone will get you out of pain, but he often remarks he wonders if it's because he forgets he's in pain or if it blocks neural transmitters? Often he forgets day to day things, but being able to move around and loose 12 lbs this last month and actually bend has been a tremendous boost to his wanting to be active and go and do to loose weight.

    I've become a master at - OH BOY I'M WHIPPED let's take a break - when I'm not really so that he doesn't over do and doesn't feel like he's less of a help to me.

    Hugs for your day - and if you've found something that works - GO FOR IT and live your life =a day at a time, out of pain as you can.
  11. TerryJ2

    TerryJ2 Well-Known Member

    I agree. There's a benefit-to-risk-ratio and clearly, your quality of life would be better on the medications. I'd get to a really high functioning level and see what you can do to further your healing or diagnosis and worry about the addiction later. You can always back off on the medications once you're physically comfortable, and you can create your own pain mgmt program, but I'd sign up for a professional pain mgmt treatment plan because I work well when I have someone else to be accountable.
    Take care!!!!!
  12. Shari

    Shari IsItFridayYet?

    Hey, Timer. The last thing I'd be worried about in your shoes is addiction! What good is life if you hurt too bad to live it?

    I am thought to have something called RSD - reflex sympathetic dystrophy. Not sure how to explain it, but in a nutshell, I sometimes experience physical pain long after the original injury is gone, particularly if the pain was allowed to go unchecked. Its almost like untreated pain breeds more pain, even when the source of the first pain is gone. If that makes sense.

    For me, it is easier to maintain control of the pain than it is to get control of the pain in the first place. I would imagine with the level of your pain and the amount of time you've suffered that perhaps this sort of approach may be helpful to you, too.

    Therefore, my vote, take the pain medications. Live your life.
  13. DammitJanet

    DammitJanet Well-Known Member Staff Member

    As another chronic pain sufferer, I simply dont believe we get addicted to pain medications the way people think of the word addiction. We may become dependent to them for a quality of life but Im dependent on oxygen too so I refuse to worry about it. We have a right to live as pain free as we can. If we feel better, we can do more. Thats the simple truth.

    By the way, where did you get your stool for the kitchen? I need one badly!
  14. timer lady

    timer lady Queen of Hearts

    I'm more & more convinced this is the route. When my pain is out of control so is the rest of my life.

    Until/unless a doctor has a major concern I will continue to use the pain medications & attempt to rebuild my strength ~ heck my life.

    Marg, I hope you know I was kidding you. You are a fount of information. If your reply is shorter than normal I get concerned over your health.

    Thank you ladies ~ onward & upward. :peaceful:
  15. SRL

    SRL Active Member

    Linda, have your doctors recommended going the pain management clinic route to devise a more comprehensive plan for you? No doubt medications would be part of that plan but an interdisiplinary approach might yield better results with less medication.
  16. Marguerite

    Marguerite Active Member

    Linda, I'm fine. I had already in the previous post said most of what I needed to say, that's all. A PM is on the way.

    A point to make - I'm not sure if I made it clearly enough. I've done the rounds of various pain management options, and here is where I am.

    * NSAIDS are aspirin-type medications, which make me really ill. They are very good for pain but increase clotting time and can cause stomach problems.

    * paracetamol is really good, but not as effective as aspirin. However, if you take too much at once you can die from liver failure.

    * opiates such as codeine, morphine, pethidine, methadone, heroin - they get potentiated (ie effect increased) by a number of other drugs, including the two above. Also, alcohol. They are fabulous at knocking the pain, but if you allow yourself to experience a 'high', you risk taking it for the high and not for the relief of pain. THAT is when you risk addiction. Also, the dosage will increase fairly soon after you begin to take it - your body adjusts to it quickly, you find you need more to get the same effect. BUT - this increase should slow dramatically, you should be able to maintain on the same dose for a very long time, only increasing over time very slowly unless the pain dramatically increases. Your body adjusts in other ways - opiates are constipating, but after a few weeks your body adjusts back to where it was. However, if you suddenly stop it, your body which had adapted to the opiate suddenly has an increased gut motility and you get diarrhoea. Opiates otherwise are the gentlest on your body. No stomach problems, no liver problems. Some people can't tolerate them, though - they can get hallucinations, or nausea/vomiting. If you can tolerate it, that's great.

    * antidepressants are supposed to help with long-term pain management. They take a while to kick in, and have other effects too. I can't take them, but for those who can, they are an option.

    * anticonvulsants are also good for reducing pain. You need to be on them for a few days at least before you get improvement beginning, but they can be a good help. However, you need to keep a close eye on liver function.

    For me, morphine is the safest option I have available, as well as darned effective. But because there is so much misunderstanding about it, a lot of stigma and a lot of hysteria, I don't tell people. Very few people actually know. My immediate family knows although I don't make a noise about it (so possibly difficult child 3 doesn't know, or understand). mother in law knows, but only recently. My siblings - maybe a couple of them know, but I'm not sure. A couple of friends know, but most of them do not.

    I did confide in a friend once. I was taking codeine, not morphine back then. He was going through his own pain management issues (which he medicated with alcohol - not a good idea) but when he turned out to be a backstabber, he used the information against me and broadcast his opinion that I was mentally disturbed because I was an addict; that the recent diagnoses of the boys as being on the autism spectrum was me shopping for a diagnosis because of Munchhausen's by proxy; and other very nasty stuff. I kept my dignity and did NOT in turn tell people that he drank spirits to dull his pain. It taught me to not lay my burdens of confidence on my friends. If I don't tell them secrets, they don't have to keep secrets. A secret is best kept if not shared with anybody.

    Linda, treat your pain. Learn to listen to your body, get the pain managed, and remember that this is very old, very safe medication. ANd if your pain ever improves SUDDENLY to the point where you can stop the opiates, THEN worry about getting off them. It will be easier than coming off prednisone.

    And of course if the pain improves gradually, you will come off the opiates gradually and naturally anyway, there should be no problem.

    Remember how long I've been on it. Most people around me just don't know, and the ones that do find it hard to believe, when they see how much I do. I see my specialist at a hospice, so I'm around people who are terminally ill, and I'm not; but it's OK. I fit in, I belong. And most important - I function now. Instead of waiting to recover, I can now get on with living in the meantime.